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International replications, anyone?
  1. L LAKATOS
  1. Department of Paediatrics
  2. Kenézy County Hospital
  3. H-4043 Debrecen
  4. Bartók
  5. B.u. 2-26
  6. Hungary
  7. Children’s Hospital
  8. Strong University of Rochester
  9. Box 651
  10. 601 Elmwood Avenue
  11. Rochester
  12. NY 14642
  13. USA
  14. Department of Paediatrics
  15. 1200 Main Street West
  16. Hamilton
  17. Ontario
  18. Canada L8N 3Z5
    1. D L PHELPS
    1. Department of Paediatrics
    2. Kenézy County Hospital
    3. H-4043 Debrecen
    4. Bartók
    5. B.u. 2-26
    6. Hungary
    7. Children’s Hospital
    8. Strong University of Rochester
    9. Box 651
    10. 601 Elmwood Avenue
    11. Rochester
    12. NY 14642
    13. USA
    14. Department of Paediatrics
    15. 1200 Main Street West
    16. Hamilton
    17. Ontario
    18. Canada L8N 3Z5
      1. J WATTS
      1. Department of Paediatrics
      2. Kenézy County Hospital
      3. H-4043 Debrecen
      4. Bartók
      5. B.u. 2-26
      6. Hungary
      7. Children’s Hospital
      8. Strong University of Rochester
      9. Box 651
      10. 601 Elmwood Avenue
      11. Rochester
      12. NY 14642
      13. USA
      14. Department of Paediatrics
      15. 1200 Main Street West
      16. Hamilton
      17. Ontario
      18. Canada L8N 3Z5

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        Editor—Chowrimooto et al recently pointed out that: “fetal copper metabolism is different from that of the adult,...with apparent similarity to Wilson’s disease.”1 It is well known that the copper chelating agent D-penicillamine (DPA) leads to a clinical improvement in hepato-lenticular degeneration without common toxic effects. Why, then, we wonder, has the demonstration of an effective mode of prevention of retinopathy of prematurity (ROP) in two randomised trials conducted more than 10 years ago in Hungary,2 failed to encourage others to undertake the independent replications needed to verify or refute such a promising approach?

        We were surprised by the following statement in a recently published English language text: “there are no data on D-penicillamine administration to neonates.”3 This assertion was particularly vexing because one of us reported on the successful use of DPA for neonatal hyperbilirubinaemia as far back as the 1970s.4 DPA has been used extensively in Hungary for treating neonates after pre-clinical laboratory research and data from controlled clinical trials. Frustratingly, no efforts seem to have been made by others to repeat this work.

        The Cochrane Collaboration is working hard to break down the language barriers that have left so many non-English speaking medical scientists apparently unheard. Furthermore, we would like to draw attention to a recent Cochrane review which we conducted on the existing evidence from controlled trials on the use of DPA in premature infants with ROP and survival as the outcome measure. The consensus reached was that: “DPA is unlikely to affect survival and may reduce acute ROP among the survivors.” Studies to date, it was concluded, “justify further investigation of this drug in a broader population.”5

        English speaking doubters, we suggest, should now take up this challenge.

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